Metformin

Metformin is a commonly-prescribed medicine licensed for polycystic ovary syndrome and diabetes. It can also be helpful in the treatment of acne in females. It is inexpensive and has a good safety profile, so much so that it can be prescribed during pregnancy in patients with diabetes. It is best taken with food to avoid abdominal upset, and is usually well-tolerated.

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It can lower the blood levels of  Vitamin B12, so the serum Vitamin B12 levels should be measured once a year in those taking metformin long-term. Weight loss may occur in people taking metformin, which can explain some of its benefits in diabetes and polycystic ovary syndrome. The exact mechanism of its benefits in acne treatment are unclear, but in our experience many patients find it very helpful, with improvement beginning after a couple of months. It is not a cure for acne and may need to be taken long-term.